Bitter cold and MVA's

[ClutzyEMT]

Recently had a very tough call that involved extended extrication +30mn times, blizzard like conditions, and below 40 wind chills....

Wondering what others do to keep not only themselves warm, but their patient's as well...are there things others are doing?

Looking for input besides the warm I'V fluids and blankets...

[scubanurse]

Pocket warmers, we would have a canteen come with hot fluids, warm IV fluids for the patient:( it's a tough call.

[P_Instructor]

Tough situation....one that you hope is rarely seen. However, can be very taxing when confronted with this type of scenario. One cannot routinely be prepared for this type of call unless working in that area/environment all the time. I would think out of the box and use common sense. On scene, utlilize shifts on the extrication if possible. One idea would be to get the biggest, heftiest tarp available and cover the car/patient to keep the wind off. That would be the biggest problem ... the wind chill (patient and providers).

What was the outcome?

[mobey]

Here in Canada, these situation are buisness as usual.

Don't underestimate the tinfoil sheets, best to put them next to the skin if possible. Just wrap thier torso.

Pocket warmers for yourself. Put them in your pockets and boots on a prolonged extrication.

Biggest thing is wind. Try to keep as many windows intact as possible.

ITLS does not recognize extreme weather as a "Emergency maneuver" worthy situation.

But when faced with a wet patient, in -32C with a wind chill, it does not take long for hypothermia to take effect.... in fact it probably started before you're arrival. Since Hypothermia is one of the lethal triad, protection of C-Spine can become grey....

[ClutzyEMT]

Unfortunately, working in those conditions have become common place here as well this winter. I had no choice with the windows tho, as three side ones and the front window were already gone when we got on scene..my pt's lower legs were entrapped otherwise I most likely would have controlled c-spine as best as possible and undergone rapid extrication.

I just keep thinking that somewhere, someone has devised something to help protect us and our pt's a little better in these situations.... wishful thinking perhaps.

Unfortunately my pt succumbed to her combination of hypothermia and life threatening injuries with prolonged extrication and I am still nursing some frost bitten fingers and toes despite the heat packs designed for gloves and boots. I almost think the heat packs excarberated the cold once they lost their'internal' heat.

[island emt]

About the only thing that can be done is to have the fire guys pull out tarps and block the wind the best they can. If the weather conditions are really ferocious I always put on my insulated arctic boots and " thinsulate bibs used for duck hunting. They are wind proof and reasonably waterproof. They may not look like a uniform , but they do keep me warm.

We use space blankets and hot packs for Pt's and if we have access will get a warmed IV running.Our IV warmer bag is 12 volt and can be left plugged in and leave the spiked bag inside & warm while infusing.

The odds are your pt was in trouble and might not have survived the injuries even without the added problem of hypothermia.

[scubanurse]

You could look into a support unit to bring out large area heaters... not sure how that would have helped this situation though.

[Chief1C]

People - Turnout Gear is warm; rotate crews, warm them in the trucks. Bring in additional EMS units for cold weather rehab, assign a rehab officer to monitor personnel for signs of hypothermia. Don't be afraid to take someone's boots away if they look like they've had too much. Patients - Ready Heat II, forget heat packs, they'll fail below zero. Put the IV bags in Infant Warming pouches, also Ready Heat products. Shield the vehicle with a truck, if possible. Use the equipment gently. If hydraulic lines are going to fail, it's gonna be in the cold.

[systemet]

Recently had a very tough call that involved extended extrication +30mn times, blizzard like conditions, and below 40 wind chills....

Is that below 40F or below -40F ? One of these is a bigger problem than the other.

[ClutzyEMT]

Sorry System.. -40 wind chills. The actual temp was around -19 with wind blowing up to 30mph at times. I am going to check with our local fire dept and see if they have an extra pair of the turn out pants. We did not have the available resources that night due to the weather conditions to rotate people out although I like that plan and will be working on some 'Extreme weather' SOP's to help guide in the future.